Quitting smoking linked to improved mood

NEW YORK (Reuters Health) - Smokers who kick the habit
appear to benefit from an improved mood, according to a new
review of past studies.

On average, quitting smoking was associated with
improvements in mental health similar to taking an
antidepressant drug, a team of UK researchers found.

"The main message is that when people stop smoking, they
feel better than they did when they were smoking," Dr. Paul
Aveyard, one of the review's authors, told Reuters Health.

"People who quit smoking may feel grumpy, irritable and bad
- those feelings are similar to feelings of stress and people
conflate the two," Aveyard, from the University of Oxford, said.

"For clinicians like myself, when we see people who smoke
who also have mental health difficulties, there's often a
feeling that we are depriving them of a way to deal with the
stress," he said. "But in fact we are helping these people to
get better."

It is widely known that quitting smoking has saved lives
(see Reuters Health story of January 7, 2014 here: http://reut.rs/1cWYYvJ).
But it's nearly impossible to prove that smoking causes
specific health problems, or that quitting prevents them,
because of other differences that exist between smokers and
non-smokers that could impact health and well-being.

With that in mind, "the claim of this paper that quitting is
as good as drugs needs more research," Dr. Prabhat Jha, of the
University of Toronto Centre for Global Health Research in
Canada, wrote in an email to Reuters Health. Jha was not part of
the new analysis.

For their review, the researchers examined data from 26
studies of smoking cessation. Some studies included smokers in
the general public and others focused on people in psychiatric
hospitals. Participants smoked an average of 20 cigarettes per
day initially.

All of the studies assessed participants' mental health
before quitting smoking and about six months later, on average.

Compared to people who continued to smoke, the studies
showed drops in anxiety, depression and stress and improvements
in psychological quality of life among quitters.

Other explanations related to mood improvements among
quitters need to be considered, the researchers write in the
British medical journal BMJ. For example, it's possible that
life events improved people's mood, leading them to quit
smoking.

Still, there is "an entrenched belief in our culture that
smoking 'calms the nerves' and can help alleviate stressful
situations," psychiatry researcher Benjamin Le Cook of the
Cambridge Health Alliance in Somerville, Massachusetts told
Reuters Health in an email. He said this message has met little
resistance from public health, mental health and medical
communities so far.

The current review serves as a reminder that tobacco
withdrawal symptoms like anxiety can easily be confused with
mental health problems, said Brian Hitsman of the Northwestern
University Feinberg School of Medicine in Chicago. Both he and
Le Cook were not involved in the review.

"It's possible that the emotional withdrawal symptoms are
interpreted as an acute worsening of psychiatric symptoms,"
Hitsman wrote in an email to Reuters Health.

Aveyard and his colleagues conclude that people who smoke
"can be reassured" that quitting is tied to improved mental
health.